不同手术方式治疗异常子宫出血对卵巢功能的影响
作者: |
1王坚青
1 盐城市第一人民医院妇产科,江苏 盐城 224006 |
通讯: |
王坚青
Email: Wangjq368@163.com |
DOI: | 10.3978/j.issn.2095-6959.2016.11.009 |
摘要
目的:探讨不同手术方式治疗异常子宫出血对卵巢功能的影响。方法:选取2013年12月至2016年1月在我院接受治疗的异常子宫出血患者114例,按随机数表法将所有患者分成三组,其中A组患者38例,行子宫全切术;B组患者的38例,行子宫内膜电切术;C组患者38例,行子宫内膜去除术,观察并比较三组患者术前、术后3个月以及术后6个月的激素水平和术后排卵情况。结果:比较得知,术前、术后3个月和术后6个月,A组患者FSH、LH、E2水平差异较大,其中FSH和LH呈上升趋势,E2呈下降趋势,结果具有统计学差异,P<0.05;B组和C组患者性激素水平虽有较小波动,但组内和组间均无显著性差异,P>0.05;A组患者和B、C组患者相比,术后3、6个月各项指标均有差异,P<0.05;三组患者术后排卵功能恢复正常情况差异较大,其中C组患者总恢复率(80.95%)和B组患者总恢复率(71.05%)明显大于A组患者(40.63%),C组患者恢复情况最为显著,结果具有统计学差异,P<0.05。结论:三种手术治疗方式中,子宫全切术后6个月即开始出现卵巢早衰的征象,而子宫内膜电切术和子宫内膜去除术对卵巢功能影响较小,又因子宫内膜去除术简单高效,术后患者卵巢功能恢复较好,建议选择子宫内膜去除术。
关键词:
异常子宫出血
卵巢功能
子宫全切术
子宫内膜电切术
子宫内膜去除术
Effect of different operation methods on ovarian function in abnormal uterine bleeding
CorrespondingAuthor: WANG Jianqing Email: Wangjq368@163.com
DOI: 10.3978/j.issn.2095-6959.2016.11.009
Abstract
Objective: To investigate the effects of different operation methods on ovarian function in abnormal uterine bleeding. Methods: 114 cases of abnormal uterine bleeding patients were selected from December 2013 to January 2016 in our hospital for treatment, all patients were divided into three groups according to the random number table, 38 cases of patients in group A received endometrial electrical resection; 38 cases of patients in group B received transcervical resection of endometrium (TCRE); 38 cases of patients in group C received endometrial ablation (EA), the hormone levels of three groups were observed and compared before, 3 and 6 months after operation. Results: Through the comparison, before operation, after operation 3 and 6 months, FSH, LH, E2 levels in group A were rather different, which FSH and LH was rising trend, E2 showed a downward trend, and the result was statistically significant (P<0.05). Although the gonadal hormone concentrations of group B and group C patients fluctuate little, but between or within groups had no significant difference (P>0.05); compared with B, group C, each index in group A were significantly different after 3 and 6 months (P<0.05); the difference of ovulation function recovery in three groups was big, the total recovery rate of the group C (80.95%) and group B (71.05%) was significantly higher than that in group A (40.63%), group C patients recovered the most significantly. The results had statistical difference, P<0.05. Conclusion: Among three surgical methods in the treatment, there are signs of premature ovarian failure after 6 months in total hysterectomy, while endometrial electric cut operation and endometrial operation has little influence on the function of ovary removal,, as endometrial removal operation is simple, and postoperative ovarian function of patients recover better, it is recommended to choose endometrial ablation.